Men's Perspectives of Common Mental Health Problems: A Metasynthesis of Qualitative Research

Historically men's mental health has not been a topic of major research or clinical interest in its own right (Addis & Cohane, 2005). Much of the early research on men's mental health came from large-scale quantitative studies focusing on gender differences in mental health. Studies either aimed to uncover the structural determinants of these differences or the methodological reasons for why women's rates of mental illness were higher (Riska, 2009). It is only in recent years that the influence of gender as a social construct in men's mental health practices has become a focus in both the men's health and social science literature. The majority of qualitative empirical studies relating to men's gendered experiences of common mental health problems are relatively recent, with most published since 2000.

A number of themes have been established in the qualitative literature so far. Briefly, these include how men's experience and expression of depression can differ substantially to women's, emphasizing physical complaints and eternalizing behavior (Brownhill, Wilhelm, Barclay, & Schmied, 2005; Danielsson et al., 2009; Danielsson & Johansson, 2005). That the ways in which men cope with their mental health problems is diverse. For example, some use avoidant strategies to cover up their depression (Brownhill et al., 2005; Chuick et al., 2009; Rochlen et al., 2010), whilst others use strategies to frame their depression as an "heroic struggle" (Emslie, Ridge, Ziebland, & Hunt, 2006). That the relationship between gender and help-seeking for mental health is more complex than originally thought (Johnson et al., 2012; Rochlen et al., 2010). Finally, that generalizations about men being silent about their mental health problems are misleading. studies have recruited men who are willing, and want, to talk about their mental health problems.

A meta-ethnography published in this journal (Hoy, 2012) was the first comprehensive review of the qualitative literature on men's lay perspectives of mental health and helpseeking, covering published literature up to 2010. This review highlights that the focus of studies has been on men's experiences of depression and professional help-seeking. Hoy's review also draws attention to the fact that many researchers suggest the poorer mental health of men can be explained by the negative impact of masculinity which results in men being unwilling or unable to seek help. More specifically, that behaviors and beliefs associated with traditional forms of masculinity such as being stoic, strong and in control are likely to be hazardous to men's health (Hoy, 2012).

Since this time there has been a substantial number of qualitative studies published investigating men's experiences of common mental health problems. The present article builds and expands on Hoy's review by conducting a qualitative metasynthesis of studies on men's perspectives of common mental health problems published since 2010. We used a qualitative metasynthesis approach developed by Sandelowski and Barroso (2007). Although there are a number of distinct perspectives on metasynthesis methodology within qualitative health research, they all represent rigorous attempts to render what exists within a body of evidence based qualitative studies into a coherent and synthesized product (Thorne et al., 2004). Moreover, metasynthesis has been promoted as a strategy for making isolated qualitative findings more accessible to clinicians, researcher and policy makers (Finfgeld, 2003; Finfgeld-Connett, 2010). It can also play an important role in adding value to systematic reviews of interventions thereby bringing qualitative research into discussions on evidencebased practice (Noyes et al., 2008).

The qualitative metasynthesis is a systematic approach to the identification and analysis of qualitative studies, a focus on the findings from those studies, and the use of qualitative methods to synthesize those findings (Thorne et al. …

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